Ghosh Partha S, Kwon Charles, Klein Melanie, Corder Julie, Ghosh Debabrata
Pediatric Neurology Center, Children's Hospital, Cleveland Clinic, Cleveland, OH, USA Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Department of Nephrology, Children's Hospital, Cleveland Clinic, Cleveland, OH, USA.
J Child Neurol. 2014 Jun;29(6):793-8. doi: 10.1177/0883073813490074. Epub 2013 Jun 10.
We reviewed neurologic complications after renal transplantation in children over a 20-year period. Neurologic complications were classified as early (within 3 months) and delayed (beyond 3 months). Of 115 children, 10 (8.7%) had complications. Early complications were found in 4.35% of patients: seizures in 4 (posterior reversible leukoencephalopathy syndrome due to immunosuppressant toxicity, sepsis/presumed meningitis, and indeterminate) and headaches in 1. One patient with seizures received levetiracetam for 6 months and 1 with headaches received amitriptyline prophylaxis. Late complications were noted in 4.35% of patients: seizures in 3 (posterior reversible leukoencephalopathy syndrome due to hypertension, hypertensive encephalopathy), headaches in 2, and tremors in 1. Two patients with seizures were treated with anti-epilepsy medications; 1 with migraine received cyproheptadine prophylaxis. Neurologic complications develop in children after renal transplantation. Seizures due to posterior reversible leukoencephalopathy syndrome were the commonest complication. Early detection and appropriate management of these complications is important.
我们回顾了20年间儿童肾移植后的神经系统并发症。神经系统并发症分为早期（3个月内）和延迟性（3个月后）。在115名儿童中，10名（8.7%）出现了并发症。4.35%的患者出现早期并发症：4例癫痫发作（分别因免疫抑制剂毒性导致的后部可逆性白质脑病综合征、败血症/疑似脑膜炎以及病因不明），1例头痛。1例癫痫发作患者接受了6个月的左乙拉西坦治疗，1例头痛患者接受了阿米替林预防性治疗。4.35%的患者出现晚期并发症：3例癫痫发作（因高血压导致的后部可逆性白质脑病综合征、高血压脑病），2例头痛，1例震颤。2例癫痫发作患者接受了抗癫痫药物治疗；1例偏头痛患者接受了赛庚啶预防性治疗。儿童肾移植后会出现神经系统并发症。后部可逆性白质脑病综合征导致的癫痫发作是最常见的并发症。早期发现并妥善处理这些并发症很重要。
